IATROGENIC VENTRICULAR SEPTAL DEFECT DURING RIGHT VENTRICULAR
ASSIST DEVICE INSERTION IN CONGENITALLY CORRECTED TRANSPOSITION OF THE
GREAT ARTERIES
Short Title: Iatrogenic VSD during RVAD implantation
Mimi Xiaoming Deng MD1, 2, Aamir Jeewa MB
BCh3, Osami Honjo MD, PhD1,2
1 Division of Cardiovascular Surgery, Labatt Family
Heart Centre, The Hospital for Sick Children, Toronto, Canada
2 Department of Surgery, University of Toronto,
Toronto, Canada
3 Division of Pediatric Cardiology, The Hospital for
Sick Children, Toronto, Canada
IRB approval and clinical trial registration are not applicable. No
external sources of funding. Case was displayed as a poster presentation
for the International Society for Heart and Lung Transplant Annual
Meeting 2021, virtual, April 24-28, 2021.
Total word count: 1390/1500
Corresponding Author: Osami Honjo, MD, PhD
Division of Cardiovascular Surgery, Labatt Family Heart Center,
The Hospital for Sick Children 555 University Avenue Toronto, ON,
Canada, M5G1X8
Email: osami.honjo@sickkids.ca
Phone: +1 416-813-6420 Fax: +1 416-813-7984
Key words: Congenital; Pediatric; Surgery; Transplant
Abstract (97/150 words)
This case report describes the management of a large iatrogenic
ventricular septal defect (VSD) created by the coring device during
systemic ventricular assist device (RVAD) insertion in a 16 year-old
patient with congenitally corrected transposition of the great arteries.
The VSD was closed by bovine pericardial patch and the ventriculotomy
was extended laterally to relocate the VAD sewing ring. After RVAD
implantation, patient initially remained cyanotic, potentially due to a
tiny VSD patch leak with right to left shunting. Hypoxia was
successfully corrected by rescue nitric oxide infusion and patient was
bridged to transplant after 91 days.